Lap Band vs. Implantable Gastric Stimulation Device

Lap Band (Adjustable Gastric Band)

A Lighter Me does not recommend the lap band procedure. A gastric sleeve operation is more affordable and often provides better results.

Overview

Adjustable gastric band surgery is done laparoscopically. It is considered one of the least invasive weight loss surgeries. During the procedure, the surgeon makes small incisions in the upper abdomen and then places a soft silicone ring with an expandable balloon around the top of the stomach. The silicone ring, or band, creates a small stomach pouch, which causes the patient to feel full after eating only a small amount of food. The band is adjustable; fluid can be added to or removed from the balloon through a port that is placed under the skin. The reduction in the intake of food, due to the patient feeling fuller more quickly, can result in significant weight loss.

Patient Eligibility

Individuals who have certain stomach or intestinal disorders, take aspirin frequently, or are addicted to alcohol or drugs are not eligible for this procedure. This procedure is only performed on individuals who are 18 or older.

Average Weight Loss Results

Weight loss results vary widely based on patient motivation and compliance. On average, most patients lose approximately 40 to 60 percent of their excess body weight after this procedure. Initially, most patients can expect to lose about 2 or 3 pounds per week, and then their weight loss will drop to about one pound per week. Adjustments to the band can be made if necessary.

Recovery Time

Most people are able to return to work one week after the procedure, and they can resume normal activities after 6 weeks.

Common Side Effects

This procedure has a moderate risk of long-term complications. Between 15 and 60 percent of patients end up needing to have the procedure completed again due to implant malposition, erosion, frequent vomiting, or lack of weight loss. Common side effects include nausea, vomiting, constipation, indigestion, ulceration at the band site, dehydration, and weight regain.

Cost

The cost of this procedure varies, but on average it costs approximately $3,500 with insurance and $15,000 without insurance.

References:
https://www.medicinenet.com/lap_band_surgery_gastric_banding/article.htm#who_are_candidates_for_the_lap_band_system
https://www.hopkinsmedicine.org/healthlibrary/test_procedures/gastroenterology/laparoscopic_adjustable_gastric_banding_135,63

Implantable Gastric Stimulation Device

Overview

Implantable gastric stimulation is a relatively new way to treat obesity. It does not change a patient’s anatomy or rely on malabsorption issues for weight loss, and it takes less than an hour to complete. It is also reversible. Using a laparoscopic approach, a device that is an electrical pulse generator, similar to a pacemaker, is implanted along the front part of the abdomen. Electrode leads are then placed in the gastric muscular wall. Once the surgery is complete and the patient has recovered, the device will be turned on, and the gastric stimulation will begin. The purpose of the device is to make patients feel fuller faster, which may help with overeating and binge eating. It is believed that when the device stimulates the stomach, a message is sent to the brain telling it that it is full.

Patient Eligibility

The ideal candidate for this procedure has a BMI over 40 or a BMI between 35 and 40 plus serious weight-related health problems.

Average Weight Loss Results

Since this is a relatively new procedure, there is not a large amount of data available regarding weight loss results. In general, it appears that patients typically lose between 5 and 17 percent of excess body weight from implantable gastric stimulation. It has been reported that some patients did not lose any weight and others actually gained weight after this procedure. Approximately 80 percent of patients have reported some weight loss, and 60 percent lost more than 10 percent of their body weight within 2 ½ years. In general, it appears that diet and lifestyle changes are necessary for weight loss to occur.

Recovery Time

Most patients are given approximately 4 weeks to recover from the procedure. Once the recovery is complete, the stimulation will begin.

Common Side Effects

Possible side effects from this procedure include abdominal pain, generalized pain, fever, and flatulence. Nausea, constipation, and hypoglycemia may also occur, but they are relatively rare.

Cost

The cost of this procedure varies, but it is likely to fall somewhere around $15,000 in the US. Insurance may or may not pay for a portion of this procedure.

References:
https://commons.pacificu.edu/cgi/viewcontent.cgi?article=1242&context=pa